Request edit access
CRHG & Surgical Center Patient Satisfaction Survey
Dear Patient: Your opinion means a great deal to us. We strive to go above and beyond your expectations. Please tell us your thoughts about your time spent with CRH&G and the services you received. Your comments are appreciated and your input helps us to continue to improve. For each answer you select the #3 we would greatly appreciate your suggestions at the end of the survey.
Thank you!

Dr. Najmabadi & CRHG Administration

Rating scale 1 = SUPER 2= SATISFACTORY 3= PLEASE MAKE A SUGGESTION


Email address *
First & Last Name *
Your answer
May we use your comments publicly on our website or social media?
Ease of making appointment: *
Super
Suggestion
The efficiency of the check-in process: *
Super
Suggestion
Was the waiting time prior to being seen reasonable: *
Super
Suggestion
Was our staff friendly and courteous: *
Super
Suggestion
Did the staff explain things in a way you could understand: *
Super
Suggestion
Were your phone calls answered promptly and your questions addressed: *
Super
Suggestion
Were your test results reported in a reasonable amount of time: *
Super
Suggestion
Were all of your forms and consents clearly explained: *
Super
Suggestion
Were your questions answered prior to any procedures: *
Super
Suggestion
Were things explained in a way you could understand: *
Super
Suggestion
Did you feel the doctor was available to you, answered your questions, addressed your concerns and made you feel comfortable: *
Super
Suggestion
Please rate your overall satisfaction with our practice: *
Super
Suggestion
Please provide any suggestions for improvement of the Center for Reproductive Health & Gynecology & CRHG Surgical Center:
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service